The effect of the scotchcast boot and the aircast device on foot pressures of the contralateral foot

Offloading the diabetic foot ulcer is a key element to successful wound healing. The aim of the current study was to determine whether offloading devices affect foot pressures on the contralateral foot. Foot pressures were measured in 22 diabetic patients wearing three different types of footwear on the foot with an active or recently healed ulcer, as follows: the post-op sandal (SAN) (Benefoot UK Ltd, Prestwich, United Kingdom), the Scotchcast boot (SCB), and the Aircast device (AIR) (Aircast, Inc., Lincolnshire, United Kingdom). The SAN was worn on the contralateral foot during all foot pressure measurements. The results showed that foot pressures in the contralateral foot were not different between the three different footwear conditions. There was also no difference in peak pressure time integral in the contralateral foot between the three different footwear conditions. However, an insignificant trend was noted for a longer contact time for the contralateral foot compared to the offloadeded foot for the SAN, SCB, and AIR (p=0.3, p=0.15, and p=0.05, respectively). Although there was only a small difference in contact time, this can lead to an asymmetric gait pattern and could potentially lead to overloading of the contralateral foot and/or to difficulties with maintaining balance while walking. In conclusion, although offloading devices do not seem to alter foot pressures on the contralateral foot, monitoring the contralateral foot is of paramount importance. Asymmetric gait pattern and/or difficulties with balance are essential factors to keep in mind when describing offloading devices to patients with peripheral neuropathy.